Cardiology Referral Form

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Please contact Capital City Specialty & Emergency Animal Hospital at (613) 244-7387 if you need assistance with any referral.

If the attachments surpass the maximum 50MB file size, please email the patient’s records and imaging directly to cardiology@capcityvet.com.

a cat lying on a couch

REFERRAL DETAILS

Max. 5000 Characters
0 of 5000 max characters

REFERRING VETERINARIAN INFORMATION

CLIENT INFORMATION

PATIENT INFORMATION

All cats require a prescribed dose of Gabapentin for this appointment, regardless of FAS score.

General sedation recommendation guidelines

As the referring veterinarian, it is your responsibility to determine the appropriate dose of sedation for your patient. Please follow the recommended dosing guidelines below:

Cats: 100 mg Gabapentin, the night before and morning of the appointment

Dogs: Trazodone 3-5 mg/kg and/or Gabapentin 10 mg/kg, 1-2 hours before the appointment.

FILES

Please include all documents which are relevant to the presenting complaint here.

The following files are attached:

Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.
Max. file size: 50 MB.

Please make sure your file name does not include any special characters ($&^* etc.) as this can corrupt the file submission.